The role of atrial vessels in aortic root and mitral valve operations

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The role of atrial vessels in aortic root and mitral valve operations Gustavo Abuin, MD, Alejandro Nieponice, MD, Silvio Martinez, MD, Cichero Fernando, MD The Annals of Thoracic Surgery Volume 70, Issue 4, Pages 1234-1237 (October 2000) DOI: 10.1016/S0003-4975(00)01660-X

Fig 1 Bentall procedure. (A) The right superior descending artery (arrow) surrounding the aortic root. (B) Simulation of Bentall procedure with aortic root replacement and attachment of the coronary pedicles. (Ao = aorta; AV = atrioventricular node; RC = right coronary artery.) The Annals of Thoracic Surgery 2000 70, 1234-1237DOI: (10.1016/S0003-4975(00)01660-X)

Fig 2 Yacoub procedure. (A) Kügel’s artery (arrow) lying over the interatrial septum behind the aortic root before the simulation. (B) The aortic root was removed, preserving the native valve. (C) The aortic valve and the coronary pedicles ready for the grafting. (D) Placement of the aortic graft and attachment of the coronary pedicles. See how the suture “captures” Kügel’s artery (arrow). (Ao = aorta.) The Annals of Thoracic Surgery 2000 70, 1234-1237DOI: (10.1016/S0003-4975(00)01660-X)

Fig 3 Guiraudon approach. Kügel’s artery (arrow) is surrounding the aortic root, passing near the surgical incision. (Ao = aorta; IAS = interatrial septum; MV = mitral valve [posterior leaflet]; RA = right atrium.) The Annals of Thoracic Surgery 2000 70, 1234-1237DOI: (10.1016/S0003-4975(00)01660-X)

Fig 4 Atrial vessels supplying the atrioventricular (AV) node. (A) Kügel’s artery (KA) and right superior descending (RSD) in a posterior view of the heart. (B) Sinoatrial (SA) node artery supplying the sinoatrial node area in an anterior view of the heart. (AO = aorta; AVNA = AV node artery; Cx = circumflex artery; LCA = left coronary artery; RA = right atrium; RCA = right coronary artery; RV = right ventricle.) The Annals of Thoracic Surgery 2000 70, 1234-1237DOI: (10.1016/S0003-4975(00)01660-X)